Preventing nerve function impairment in leprosy: validation and updating of a prediction rule.
BACKGROUND: To validate and update a prediction rule for estimating the risk of leprosy-related nerve function impairment (NFI). METHODOLOGY/PRINCIPAL FINDINGS: Prospective cohort using routinely collected data, in which we determined the discriminative ability of a previously published rule and an...
Published in: | PLoS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2008
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0000283 https://doaj.org/article/91901f9ed44642d9beecee11b04999e8 |
id |
ftdoajarticles:oai:doaj.org/article:91901f9ed44642d9beecee11b04999e8 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:91901f9ed44642d9beecee11b04999e8 2023-05-15T15:10:42+02:00 Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. Ron P Schuring Jan H Richardus Ewout W Steyerberg David Pahan William R Faber Linda Oskam 2008-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0000283 https://doaj.org/article/91901f9ed44642d9beecee11b04999e8 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC2565693?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000283 https://doaj.org/article/91901f9ed44642d9beecee11b04999e8 PLoS Neglected Tropical Diseases, Vol 2, Iss 8, p e283 (2008) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2008 ftdoajarticles https://doi.org/10.1371/journal.pntd.0000283 2022-12-31T02:25:50Z BACKGROUND: To validate and update a prediction rule for estimating the risk of leprosy-related nerve function impairment (NFI). METHODOLOGY/PRINCIPAL FINDINGS: Prospective cohort using routinely collected data, in which we determined the discriminative ability of a previously published rule and an updated rule with a concordance statistic (c). Additional risk factors were analyzed with a Cox proportional hazards regression model. The population consisted of 1,037 leprosy patients newly diagnosed between 2002 and 2003 in the health care facilities of the Rural Health Program in Nilphamari and Rangpur districts in northwest Bangladesh. The primary outcome was the time until the start of treatment. An NFI event was defined as the decision to treat NFI with corticosteroids after diagnosis. NFI occurred in 115 patients (13%; 95% confidence interval 11%-16%). The original prediction rule had adequate discriminative ability (c = 0.79), but could be improved by substituting one predicting variable: 'long-standing nerve function impairment at diagnosis' by 'anti-PGL-I antibodies'. The adjusted prediction rule was slightly better (c = 0.81) and identified more patients with NFI (80%) than the original prediction rule (72%). CONCLUSIONS/SIGNIFICANCE: NFI can well be predicted by using the risk variables 'leprosy classification' and 'anti-PGL-I antibodies'. The use of these two variables that do not include NFI offer the possibility of predicting NFI, even before it occurs for the first time. Surveillance beyond the treatment period can be targeted to those most likely to benefit from preventing permanent disabilities. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLoS Neglected Tropical Diseases 2 8 e283 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Ron P Schuring Jan H Richardus Ewout W Steyerberg David Pahan William R Faber Linda Oskam Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND: To validate and update a prediction rule for estimating the risk of leprosy-related nerve function impairment (NFI). METHODOLOGY/PRINCIPAL FINDINGS: Prospective cohort using routinely collected data, in which we determined the discriminative ability of a previously published rule and an updated rule with a concordance statistic (c). Additional risk factors were analyzed with a Cox proportional hazards regression model. The population consisted of 1,037 leprosy patients newly diagnosed between 2002 and 2003 in the health care facilities of the Rural Health Program in Nilphamari and Rangpur districts in northwest Bangladesh. The primary outcome was the time until the start of treatment. An NFI event was defined as the decision to treat NFI with corticosteroids after diagnosis. NFI occurred in 115 patients (13%; 95% confidence interval 11%-16%). The original prediction rule had adequate discriminative ability (c = 0.79), but could be improved by substituting one predicting variable: 'long-standing nerve function impairment at diagnosis' by 'anti-PGL-I antibodies'. The adjusted prediction rule was slightly better (c = 0.81) and identified more patients with NFI (80%) than the original prediction rule (72%). CONCLUSIONS/SIGNIFICANCE: NFI can well be predicted by using the risk variables 'leprosy classification' and 'anti-PGL-I antibodies'. The use of these two variables that do not include NFI offer the possibility of predicting NFI, even before it occurs for the first time. Surveillance beyond the treatment period can be targeted to those most likely to benefit from preventing permanent disabilities. |
format |
Article in Journal/Newspaper |
author |
Ron P Schuring Jan H Richardus Ewout W Steyerberg David Pahan William R Faber Linda Oskam |
author_facet |
Ron P Schuring Jan H Richardus Ewout W Steyerberg David Pahan William R Faber Linda Oskam |
author_sort |
Ron P Schuring |
title |
Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
title_short |
Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
title_full |
Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
title_fullStr |
Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
title_full_unstemmed |
Preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
title_sort |
preventing nerve function impairment in leprosy: validation and updating of a prediction rule. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2008 |
url |
https://doi.org/10.1371/journal.pntd.0000283 https://doaj.org/article/91901f9ed44642d9beecee11b04999e8 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 2, Iss 8, p e283 (2008) |
op_relation |
http://europepmc.org/articles/PMC2565693?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0000283 https://doaj.org/article/91901f9ed44642d9beecee11b04999e8 |
op_doi |
https://doi.org/10.1371/journal.pntd.0000283 |
container_title |
PLoS Neglected Tropical Diseases |
container_volume |
2 |
container_issue |
8 |
container_start_page |
e283 |
_version_ |
1766341670640549888 |